Therapeutic Aspects of Brain Tissue pO2 Monitoring after Subarachnoid Hemorrhage

Väth, Albert; Kunze, Ekkehard; Roosen, K.; Meixensberger, Jürgen

doi:10.1007/978-3-7091-6738-0_78

Cited by 33 publications

(29 citation statements)

References 6 publications

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“…Flow velocities below 120 cm/s (absence), >200 cm/s (presence), MCA/ICA ratio >6 (presence), or rapidly increasing velocities over several days (high risk) are commonly considered thresholds [140,141]. Brain tissue oxygen (PbtO 2 ) monitoring and cerebral microdialysis (CMD) for patients with SAH have both been described in numerous observational studies [142][143][144][145][146]. These physiological parameters are directly measuring tissue oxygen delivery and metabolism, and thus may provide complementary information to that from radiographic studies rather than direct correlation.…”

Section: Monitoringmentioning

confidence: 99%

Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference

et al. 2011

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Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.

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Section: Monitoringmentioning

confidence: 99%

Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference

et al. 2011

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“…In this small study, 10 patients with SAH who developed vasospasm had significantly lower brain tissue pH and higher PCO 2 compared with controls; however, there was no significant change in PO 2 levels associated with vasospasm [9]. A subsequent study with 11 patients published in 2001 found a strong correlation in [11] demonstrated the first direct correlation between PtiO 2 and the development of ischemic events in 32 patients. Two later studies correlated PtiO 2 values with angiographic vasospasm (N = 14) [12], and patient outcome (N = 42) [13].…”

Section: Electroencephalography (Eeg)mentioning

confidence: 68%

Monitoring and Detection of Vasospasm II: EEG and Invasive Monitoring

Hänggi

2011

Neurocrit Care

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Several non-invasive and invasive modalities have been used to monitor patients for cerebral ischemia after subarachnoid hemorrhage. A literature search was performed to identify original research studies testing monitors that may be used in addition to the standard measures of brain function and cerebral blood flow. Fifty observational studies were identified that evaluated the role of electroencephalography, brain tissue oxygenation monitoring, cerebral microdialysis, thermal diffusion flowmetry, or near-infrared spectroscopy in patients after subarachnoid hemorrhage.

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“…A promising strategy that is already being used in many neurotrauma centers for TBI management is continuous brain tissue oxygen (P bt O 2 ) monitoring. P bt O 2 probes have been successfully used in screening patients with aneurysmal subarachnoid hemorrhage [59,60], and have proven effective in demonstrating the therapeutic effects of induced hypertension [61] and balloon angioplasty [62]. LicoxÒ probes (Integra NeuroSciences, Plainsboro, NJ) are simple to use, highly accurate, and have become increasingly popular in modern-day neurocritical care units [63].…”

Section: Screening For Ptvmentioning

confidence: 99%

Posttraumatic Vasospasm Detected by Continuous Brain Tissue Oxygen Monitoring: Treatment with Intraarterial Verapamil and Balloon Angioplasty

et al. 2008

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Therapeutic Aspects of Brain Tissue pO2 Monitoring after Subarachnoid Hemorrhage

Cited by 33 publications

References 6 publications

Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference

Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference

Monitoring and Detection of Vasospasm II: EEG and Invasive Monitoring

Posttraumatic Vasospasm Detected by Continuous Brain Tissue Oxygen Monitoring: Treatment with Intraarterial Verapamil and Balloon Angioplasty

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